injury

People often wonder, if I go to physical therapy will it hurt? Sometimes I’ve heard people say “PT” stands for “pain and torture.”

So, does physical therapy hurt? This is the good news: most of the time the answer is NO!

When will physical therapy hurt? Once in a while the answer is yes, BUT that is because of the surgery you have had and the steps that you need to go through to get past the normal side effects of having a surgery. What surgeries will be more painful to rehabilitate from? In my experience as a physical therapist, new knee replacements seem to be the most painful. Second to that is shoulder surgery. The worse pain is usually there for a while only then gets better as you recover and move more, usually within a few weeks to a month.

When should physical therapy be comfortable? Most of the time physical therapy should be comfortable and make you feel better as each treatment progresses. The old adage of “no pain no gain” does NOT apply. When you have an injury, working weak muscles until they are tired will be a good limit of exercise; if you push past the muscle you are working feeling tired (heavy and achey) you might cause more pain because your body is working in its weak zone and that is when more pain happens.

Will there be soreness after my physical therapy session? It is pretty common for patients to feel sore after their PT appointment, especially your first visit because we have to have you move a lot to fully evaluate your problem. Sometimes after introducing a new exercise, or increasing resistance you will be sore too. You should not be in pain, however and if your soreness is there for more than 1-2 days, speak up on your next PT session because that is too long.

Most of the time physical therapy should be comfortable and leave you feeling good!

Here is an interesting case of a patient who injured her right knee with a cartilage tear about 15 months ago.

Her hip responded to the right knee injury by twisting in at the thigh and out at the shin. The angle between the upper leg and lower leg is about 25 degrees, and on the left, her normal leg is about 10 degrees.

After one treatment, and some home exercises her knee looked like this:

At Comstock Physical Therapy we treat all kinds of folks, younger, older, and in between. We treat athletes from club teams, recreational athletes and folks with other, more unique kinds of injuries.

This young man received an ankle sprain when falling off his skateboard and had a lot of pain walking an appreciable distance when he first came to physical therapy. He had difficulty even fully squatting to tie his shoes, or pick something up from the ground. He was not able to skateboard, which is his long term goal.

After he started physical therapy, it was found that he had pain with squatting due to pinching and painful feeling where he actually sprained his ankle, on the outside and front of the ankle. The ligament is called the anterior talofibular ligament.

The ligament swelled and got pinched. After moving the specific joints to improve his ability to squat, and giving him strengthening exercises, he began to get better. His exercises inclued balance exercises on a dynadisc, theraband exercises for strengthening and range of motion exercises to improve his mobility both with his foot up in the air (open chain exercises) and with his foot in the ground and him in the sitting position (closed chain with partial weight bearing).

After about 4 weeks we put him on an IJOY machine which challenges patients in side to side motions and kind of moves like a skateboard. Here is a picture of how he did:

After another week he got quite a bit better and actuallty did a 180 flip on the IJOY

This week I've asked him to skateboard on a dry, flat surface and he has been cut down to 1x/week. Hopefully he'll be done sone and back to the sport he loves:

Here it is: the fix for shoulder blade/scapular weakness on one side that makes progressing your P90X workout, or any upper body workout for that matter, harder.

If you follow the above links you will see how to strengthening one-sided shoulder girdle problems. When the shoulder girdle is weak, it can cause winging. If it is just a little weak, like it is with this lady, then you may have headaches, because of the stretch to the upper trapezius. You might also develop rotator cuff impingement due to this problem.

How do you develop shoulder blade weakness? Usually it hppens because you might have an arm injury, which can make your muscle weak as they try to protect you and stop you from using an injured body part. Other causes can be prolonged computer use in which your arms and shoulder are held in the shoulder forward position.